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Detection of carbapenemase producing klebsiella pneumoniae by phenotypic method

Author: 
Dr. Mohd. Arif, Dr. Dinesh Verma, Dr. A. S. Dalal and Dr. Anamika Vyas
Subject Area: 
Health Sciences
Abstract: 

Introduction: There are several components of normal microbial flora in human intestine and the second most common aerobic bacterial flora is Klebsiella species after Escherichia coli. (Podschum et al., 1998) Klebsiella also accompanies extensive resistance to most of the available antibiotics. Resistance to beta-lactam drugs in gram negative is mainly conferred by beta-lactamase- enzymes that inactivate beta-lactam antibiotics by hydrolysis. (Ghafourian et al., 2011) There for this study was designed to determine Carbapenemase production in Klebsiella pneumonia from various clinical samples by using phenotypic test (Combined disk test, Modified Hodge test, and (combined disk test +Modified Hodge test both). Aim and objectives: The present study was undertaken to determine Carbapenemase production in Klebsiella pneumonia from various clinical samples by using phenotypic test (Combined disk test, Modified Hodge test, and (combined disk test +Modified Hodge test both). Materials and Methods: The presnt study was conducted in department of microbiology, Geetanjali medical college Udaipur (raj). Various clinical samples were obtained from the patients who came in various outdoor and indoor department of Geetanjali medical college Udaipur (raj). 100 non duplicates clinical isolates of Klebsiella pneumonia were processed for the study. Antibiotic susceptibility testing was performed by Kirby bauer method according to CLSI guidelines and the Imipenem resistant isolates were further tested for carbapenemase production by combined-disk test (CDT) and Modified Hodge test (MHT) (Clinical Laboratory Standards Institute (CLSI), 2014) and (combined disk test +Modified Hodge test both). Observation and Results: Among 100 Klebsiella pneumomiae isolates, 14% resistance for Carbepenems (Imipenem) was observed, and 86% Carbepenems (Imipenem) sensitive. all 14 Imipenem resistant Klebsiella pneumoniae isolates, 05 (35.71%) carapenamase positive on CDT; and 04(28.57%) positive by MHT. 03 (21.4)% positive on CDT/MHT whereas 02 (14.28%) were negative on (CDT+MHT) method. Among 14 Imipenem resistant Klebsiella pneumonia isolates, 12(85.71%) were carbapenemase producer and 02(14.2%) were non-carbapenemase producer. Conclusion: To conclude, carbapenemase producing Klebsiella pneumonia isolates were relatively high in our institution. Accurate and timely detection of carbapenemase has important implications for efficient infection control and help in reducing the emergence of resistance thus decreases the morbidity and mortality rate.

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